Journal article
Adherence to international dietary recommendations in association with all-cause mortality and fatal and non-fatal cardiovascular disease risk: a prospective analysis of UK Biobank participants.
- Abstract:
- <h4>Background</h4>International dietary guidelines aim to reduce risks of all-cause mortality, cardiovascular disease (CVD), and fatal CVD often associated with poor dietary habits. However, most studies have examined associations with individual nutrients, foods, or dietary patterns, as opposed to quantifying the pooled health effects of adherence to international dietary recommendations. We investigated associations between total adherence to the World Health Organization (WHO) dietary recommendations for saturated fats, free sugars, fibre, and fruits and vegetables and all-cause mortality and fatal and non-fatal CVD.<h4>Methods</h4>We included participants from the UK Biobank cohort recruited in 2006-2010, which provided at least two valid 24-h dietary assessments. We defined adherence to dietary recommendations as ≤ 10% saturated fats, ≤ 10% free sugars, ≥ 25 g/day fibre, and ≥ 5 servings of fruits and vegetables/day. Multivariable Cox-proportional hazards models were used to investigate prospective associations with all-cause mortality and fatal and non-fatal CVD. In cross-sectional analyses, multivariable linear regression was used to examine associations with cardiometabolic risk factors.<h4>Results</h4>Among 115,051 participants (39-72 years), only 29.7%, 38.5%, 22.3%, and 9.5% met 0, 1, 2, or 3-4 recommendations, respectively. There was a lower risk of all-cause mortality among participants meeting more dietary recommendations (P<sub>trend</sub> < 0.001), with a significantly lower risk among participants meeting 2: HR 0.91 (95% confidence interval [CI] 0.85-0.97) and 3-4: HR 0.79 (95% CI 0.71-0.88) recommendations. There was no trend with CVD risk, but a significantly lower risk of fatal CVD with 3-4 recommendations: HR 0.78 (95% CI 0.61-0.98). Meeting more recommendations resulted in significant cross-sectional trends (P<sub>trend</sub> < 0.001) towards lower body fat, waist circumference, LDL cholesterol, apolipoprotein B, triglycerides, alkaline phosphatase, gamma glutammyltransferase, and hs-CRP, but higher glucose and aspartate aminotransferase.<h4>Conclusions</h4>Meeting dietary recommendations is associated with additive reductions in premature mortality. Motivating and supporting people to adhere to dietary guidelines may help extend years of healthy life expectancy.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, 889.5KB, Terms of use)
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- Publisher copy:
- 10.1186/s12916-021-02011-7
Authors
- Publisher:
- BioMed Central
- Journal:
- BMC Medicine More from this journal
- Volume:
- 19
- Issue:
- 1
- Article number:
- 134
- Place of publication:
- England
- Publication date:
- 2021-06-23
- Acceptance date:
- 2021-05-19
- DOI:
- EISSN:
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1741-7015
- ISSN:
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1741-7015
- Pmid:
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34158032
- Language:
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English
- Keywords:
- Pubs id:
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1183940
- Local pid:
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pubs:1183940
- Deposit date:
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2021-08-25
Terms of use
- Copyright holder:
- Kebbe et al.
- Copyright date:
- 2021
- Rights statement:
- © The Author(s). 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
- Licence:
- CC Attribution (CC BY)
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